Recently we studied the hearts of two patients who died from consequences of knife or bullet wounds. Although during life neither ever had clinical evidence of cardiac dysfunction, at necropsy both had origin of the left main (LM) coronary artery from either the right (R) coronary artery or directly from the right-anterior sinus of Valsalva with intramyocardial coursing within the ventricular septum to the left side of the heart. The course within the septum was 5.0 cm in the 34-year-old man and 4.5 cm in the 48-year-old man. In each patient, the LM exited from the ventricular septum anteriorly and immediately branched into the left anterior descending (LAD) and left circumflex (LC) coronary arteries which thereafter followed their usual courses. The walls of the tunneled LM in each patient were thinner than that of the R, LAD or LC coronary arteries. The course of the R coronary artery was normal. The myocardium was normal. The major coronary arteries in both patients were free of atherosclerotic plaques.